| National Provider Identifier [NPI]: | 1699970566 |
| Last Name Of The Provider | BRANAM |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5001 US HIGHWAY 30 W STE D |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468189701 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 217 |
| Number Of Services | 8745 |
| Number Of Medicare Beneficiaries | 6312 |
| Total Submitted Charge Amount | 812542.02 |
| Total Medicare Allowed Amount | 215946.67 |
| Total Medicare Payment Amount | 162367.9 |
| Total Medicare Standardized Payment Amount | 170888.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 217 |
| Number Of Medical Services | 8745 |
| Number Of Medicare Beneficiaries With Medical Services | 6312 |
| Total Medical Submitted Charge Amount | 812542.02 |
| Total Medical Medicare Allowed Amount | 215946.67 |
| Total Medical Medicare Payment Amount | 162367.9 |
| Total Medical Medicare Standardized Payment Amount | 170888.77 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1307 |
| Number Of Beneficiaries Age 65 to 74 | 2127 |
| Number Of Beneficiaries Age 75 to 84 | 1722 |
| Number Of Beneficiaries Age Greater 84 | 1156 |
| Number Of Female Beneficiaries | 3699 |
| Number Of Male Beneficiaries | 2613 |
| Number Of Non Hispanic White Beneficiaries | 5852 |
| Number Of Black or African American Beneficiaries | 287 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 97 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4432 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1880 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7161 |